A large population of cancer patients do not respond effectively to the medical treatment offered to them as mono-therapy or adjuvant to surgery or radiation therapy (Ernst & Young report 2009: Lack of Drug responsiveness). In the late stages of cancer, a non-efficacious medical treatment can be devastating to the overall prognosis.
The concept of designing a specific treatment for the individual patient was boosted in the early days of the human genome project where it was believed that elucidation of the human genome would open for “fingerprinting” the disease progression and treatment sensitivity of individual patients. Genotyping of patients has proven successful in identification of responsive patients to single targeted drugs like Herceptin (HER-2/neu expression) and Erbitux/Tarceva (KRAS mutation). However, this has not been the case when trying to match specific combination therapies to individual patients.
Conducting cell functional analysis in-vitro on cells resected from a patient (e.g. a cancer patient) has shown that a highly significant correlation exists between drug resistance and patient outcome (Mechetner E, Brünner N, Parker R J. Scand J Gastroenterol. (2010) August 9; d'Amato et al. Ann. Surg. Oncol. (2009), 16, 2848).
In order to recapitulate the physiological and pathophysiological behavior of primary cancer cells in-vitro it is recognized that the cells should be grown in three-dimensional cultures (Sato et al. (2011), 141:1762-1772; Gastroenterology Godugu C, Patel A R, Desai U, Andey T, Sams A, et al. (2013), PLoS ONE 8(1): e53708).